TECHNOLOGY USE AND PROLONGING DYING IN OLDER ADULTS

老年人的技术使用和延长死亡

• 批准号: 6393072
• 负责人: SHARON R KAUFMAN
• 金额: $ 27.41万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6393072
• 关键词: attitude; behavioral /social science research tag; clinical research; decision making; family structure /dynamics; health services research tag; hospital patient care; human old age (65+); human subject; intubation; patient care personnel relations; quality of life; respirators; terminal patient care

The goal of this 4-year qualitative anthropological study is to describe and examine how death in the context of technology use is facilitated, managed, or staved off, and to learn the values and assumptions surrounding both life prolonging and palliative strategies in the hospital setting. The study will take place on four hospital units in one community hospital in Berkeley CA. This will be an empirical, ethnographic investigation based on the collection of data by interviews with physicians, nurses, patients, families, and other hospital personnel, and by participant-observation of health care team meetings and the daily routine on hospital wards. The study has six specific aims: 1) to provide a descriptive account of life support technology use, especially mechanical ventilation, to prolong life and/or the dying process among individuals age 40 and older; 2) to learn which aspects of the intubation, maintenance, and withdrawal of life support technology are considered problematic and why; 3) to learn how staff think about their role in using life-prolonging technologies; 4) to explore the experience for families of having a relative on life sustaining technologies; 5) to investigate how meanings and decisions regarding life- prolonging technologies are influenced by hospital routines; and 6) to examine the practices health professionals employ to avoid the use of mechanical ventilation or other life prolonging measures. Coding-based qualitative data analysis will be used: cross-sectional comparison, in order to describe discrete patterns of thought, opinion and practice; thematic analysis and the case study approach, to identify themes that emerge within specific cases; and frequencies of response, in which themes, categories, and other variables are generated. The interpretive goal is to examine why closing the gap between what health consumers say they want and what actually happens with advanced technologies is so difficult.

这项为期4年的定性人类学研究的目标是描述和检查在技术使用的背景下如何促进、管理或避免死亡，并了解在医院环境中围绕延长生命和姑息策略的价值和假设。这项研究将在加利福尼亚州伯克利的一家社区医院的四个医院单元进行。这将是一项经验性的人种学调查，其基础是通过采访医生、护士、患者、家属和其他医院人员收集数据，以及通过参与观察卫生保健小组会议和医院病房的日常工作。这项研究有六个具体目的：1)描述生命支持技术的使用，特别是机械通风，以延长40岁及以上个人的生命和/或死亡过程；2)了解插管、维护和退出生命支持技术的哪些方面被认为是有问题的，以及为什么；3)了解工作人员如何看待他们在使用延长生命的技术方面的作用；4)探索家庭对生命维持技术的亲人的体验；5)调查关于延长生命的技术的意义和决定如何受到医院常规的影响；以及6)检查卫生专业人员为避免使用机械通风或其他延长生命的措施而采用的做法。将使用基于编码的定性数据分析：横向比较，以描述离散的思维、意见和实践模式；专题分析和案例研究方法，以确定具体案例中出现的主题；以及答复频率，其中产生主题、类别和其他变量。其解释性目标是检查为什么弥合健康消费者所说的他们想要的与先进技术的实际情况之间的差距是如此困难。